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Individual

EDNA WALTHOUR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
543 WESTFIELD RD, MIDWAY, GA 31320-3808
(912) 884-4060
Mailing address
543 WESTFIELD RD, MIDWAY, GA 31320-3808
(912) 884-4060

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
08/21/2013
Last updated
08/21/2013
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Product
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  • EDI platform